Harassment at work, patient to staff - page 3
I am a nurse in LTC and have had to deal with abuse (verbal, emotional) harassment from a patient for quite awhile now. Management knows this is going on as they have been informed repeatedley and... Read More
Mar 10, '12 by RyanCarolinaBoy, BSN, RNQuote from srimerNot sure I can agree with you on this one, dear. Mostly when I read this, I get the image of some nursing administrator who's concerned only about the bottom dollar of that "client" instead of the wellbeing of staff members. While I don't agree in unnecessary medication, I DO believe in the safety of myself and the staff members I work with. It is TOTALLY unappropriate to simply simper and smile and wave butterflies and hope everything is alright simply so we "don't have to medicate dear daddy". The very idea that healthcare professionals would write such a thing does not sit well with me. Please read the OP notes a little closer. This situation goes beyond trying to redirect a patient with a cup of tea! God forbid...that the OP need to have a career change simply because of an OUT OF CONTROL patient. This is NOT the OP's problem, but the clients. Good Lord!!I'm not quite sure if you've been educated enough to be able to handle "abuse" in LTC. Most residents are no longer able to control their behaviors, and "verbal abuse" just comes with the territory with dementia / Alzheimer's. Ask your Administrator for an in-service before you go off the deep end. Most of us who have years of experience have learned to smile with the behaviors and realize that that particular person could be a loved one someday, and do we want them medicated just so staff can "deal" with them? I say "no" and so would most state agencies. Keep your chin up and have some humor (it really helps). Or, you may want to consider a career change.
To the OP...you have my sympathy. This situation sounds totally out of control. Document, document, document. Chart behaviors, and wording. Do this consistantly, and fill out incident reports also. If patient ever physically touches you, involve the police. Asault is asault, no matter what your administration may tell you.
Mar 10, '12 by tnbutterfly, BSN, RN AdminMoved to Nurse Colleague/Patient Relations for more discussion.
Mar 10, '12 by CompleteUnknownThe resident has a brain injury and short term memory loss and I don't think you're going to be successful in reducing this behaviour without specific interventions. What has been tried so far?
Could you leave the meds until he or she comes up to you demanding them and saying you forgot? Then you can say 'oh, perhaps I did forget, let me check' and make a bit of a production of looking through everything before coming up with the meds and saying 'gosh, sorry, here they are!' The aim is to reduce the behaviour, it doesn't matter if the resident thinks you would otherwise forget or deliberately not give them or steal them or whatever it is they think. Maybe the satisfaction of believing they are right would actually be a good thing for them. It sounds like the behaviour is escalating, maybe that's because they feel that no-one is listening to them. Not saying for a second that's the way it is, just saying it's probably the way the resident sees the situation.
I wonder if he /she had a specific routine for medications prior to admission? Maybe they were always taken with breakfast or after breakfast or after cleaning teeth or at 9.30am on the dot or straight after getting dressed or any of million other things. If so, can you can you change your routine to accommodate that?
Distraction by another staff member, as mentioned by another poster, might work too. 'Come on, I'll make you a coffee and then I'll go back and ask about the medications for you, we'll get it sorted out'. Sort of good cop/bad cop thing. Perhaps the staff member who takes the resident to another area for coffee or whatever could then go back to the resident and say 'I've sorted it out for you, she'll be here with your medications in five minutes' and then in five minutes you go and give the medications. Time consuming but perhaps a possibility.
You say it happens to other staff too but it's worse with you - have you asked the staff who have the least problems what they do, or observed the way they give the medications, to see if there's anything you could change about your approach?
Is there any family and if so do they have any suggestions? If they haven't seen this and don't believe it's happening, try and get them on your side. Same for medical staff, if they haven't seen it, it's going to be hard for them to believe how bad it is. Incident reports are needed because of what is happening to you, but they generally (at least where I work) don't focus too much on what may have triggered the abuse and this is where behaviour charting is needed too. Looking for a trigger for the abuse is NOT saying you are doing anything wrong, it's just acknowledging that there may be something going on that is making this worse and looking to see if you can find what thing is and then modifying the situation so that thing is avoided.
You may not be able to eliminate this behaviour completely, probably the most you can hope for is to minimise it. If everyone together is able to come up with something it'll no doubt be time consuming but that has to be better than what's happening now.